Ascending Paresis as Presentation of an Unusual Association Between Necrotizing Autoimmune Myopathy and Systemic Lupus Erythematosus

Secondary myopathy due to systemic diseases

“…Rarely, SLE may manifest as ocular myositis . Muscle involvement in SLE may also manifest as necrotizing autoimmune myopathy with muscle weakness and rhabdomyolysis . Polymyositis is also a feature of mixed connective tissue disease, including clinical and laboratory manifestations of SLE, scleroderma, and polymyositis along with high titers of anti‐U1 and anti‐U2‐nRNP antibodies .…”

Necrotizing autoimmune myopathy

“…[ 2 5 ] Reviewing the literature, ANM is a very rare disease. [ 1 4 ] In this communication, we have highlighted the salient features of this eminently treatable condition.…”

“…ANM, a subgroup of inflammatory myopathies distinguished by minimal inflammation on histopathology, was first reported by Emslie-Smith and Engel. [ 1 ] In 2004, the Muscle Study Group proposed a separate classification for this emerging entity and the terminology of ANM was introduced taking into consideration its immunopathological, histological, and clinical aspects. [ 1 ]…”

“…[ 5 ] Laboratory evaluation discloses high levels of CK with myopathic findings on electromyography. [ 1 2 4 ] STIR images show abundant edema in the musclofascial planes, a finding which is characteristic of this disease (edema sign). On pathologic examination, muscle fibers are necrotic with a pauciimmune inflammatory infiltrate and infiltration with histiocytes.…”

“…On pathologic examination, muscle fibers are necrotic with a pauciimmune inflammatory infiltrate and infiltration with histiocytes. [ 1 2 3 ] The cause for acute necrotizing myopathy is multifactorial. [ 2 3 4 ] Fifty percent of the patients have no identifiable risk factors.…”